Mental health centers in public schools

America is abuzz with talk about mental health centers in public schools. The recent school shooting in Parkland, Fla., has sparked debate about mental health services for youth.

After the Columbine school shooting, the U.S. Surgeon General recommended community-wide psychological health services for youth, but the proposal fizzled out.

In 2001, President George W. Bush introduced a bill to Congress that would authorize emotional health assessment programs at educational facilities, but it failed to pass. The Mental Health in Schools Act of 2007 and the School-Based Health Clinic Establishment Act of 2007 never passed either.

Questions: Should mental health services be voluntary or mandatory in high schools for youth with red flag signs, symptoms and behaviors? Should high schools have their own mental health centers on school property? Where would the funding come from? What if parents refused mandatory counseling services for their children? Would an adolescent psychiatrist write medication prescriptions in a school mental health center? Who would have access to the confidential information in the files? Would students give up class time for therapy time?

Mandatory mental health centers in school

“Mandatory School-Based Mental Health Services and the Prevention of School Violence” is a 38-page article by Tessa Helle in the “2015 Health Matrix: The Journal of Law-Medicine” from the Case Western Reserve University School of Law Scholarly Commons in Cleveland, Ohio.

Helle’s introduction states, “On the morning of February 27, 2012, T.J. Lane, a 17-year-old high school student, entered a school in Chardon, Ohio, and initiated a shooting rampage.” Three students died. It was reported that Lane used a .22-caliber semiautomatic pistol.

The theory that emerged after the shooting was that Lane suffered with mental illness as he reported delusions and hallucinations. However, his lawyers dropped the insanity defense and Lane pled guilty to three counts of aggravated murder, two counts of attempted aggravated murder and one count of felonious assault. Lane was sentenced to life in prison without parole.

One of Helle’s solutions is to hire myriad school psychologists to manage student mental health needs. The National Association for School Psychologists recommends that each school district employ one school psychologist for every 500 to 700 students. However, most schools employ one psychologist for every 2,000 to 3,500 students.

A school-based mental health center would provide treatment and counseling to all students who have parental permission, regardless of insurance coverage or ability to pay.

I highly recommend the reading of Helle’s article. You can find it online at https://pdfs.semanticscholar.org/3193/53d8f14ae6646d329171670446ba344a1421.pdf.

Voluntary mental health centers in schools

Would parents accept a mental health center inside the school? Would youth seek out help when needed? Where would the funding come from?

In my opinion, school counselors are essential in the process of communicating with teachers about the mental health needs of students. School counselors are the liaison between the teachers and outside mental health professionals. But, more school counselors would need to be hired.

No mental health centers in schools

High schools differ in how they manage mental health services and how they make referrals to mental health agencies in the community. One size does not fit all. And what works in large cities may not work in rural areas. And there is a shortage of adolescent psychiatrists, psychiatric nurse practitioners, child psychologists and child therapists in rural Appalachia.

Federal special education law requires that public school districts employ school psychologists to evaluate and assess students for educational purposes. Many states mandate high schools to employ school counselors. Some school districts hire social workers. Other schools utilize school-based mental health professionals from local community mental health agencies. Some schools also utilize behavioral intervention specialists. Other schools refer parents to their insurance companies for private practices. Some schools refer the parents to their pediatric general practitioner. And many schools use a combination on a case-by-case basis.

While school mental health intervention is necessary and helpful, research supports the role of family counseling as imperative and effective. Family therapy brings parents and siblings into the treatment process as well as extended members when needed. Goals are to help family members improve communication skills, learn problem-solving skills to resolve conflicts; and expand relational interactions.

Therefore, family therapy must be a player at the mental heath services table. However, working parents usually want or need early or late evening appointments. And school districts work on a daylight schedule.

It will take talk, time, tools and legislation to find and fund mental health services for America’s youth. Solutions must be found because the valuable lives of our children are at stake.